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Machine learning techniques in a structural and functional MRI diagnostic approach in schizophrenia: a systematic review

Authors de Filippis R, Carbone EA, Gaetano R, Bruni A, Pugliese V, Segura-Garcia C, De Fazio P

Received 22 January 2019

Accepted for publication 9 April 2019

Published 19 June 2019 Volume 2019:15 Pages 1605—1627


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Roger Pinder

Renato de Filippis,1,* Elvira Anna Carbone,1,* Raffaele Gaetano,1 Antonella Bruni,1 Valentina Pugliese,1 Cristina Segura-Garcia,2 Pasquale De Fazio1

1Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro 88100, Italy; 2Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro 88100, Italy

*These authors contributed equally to this work

Background: Diagnosis of schizophrenia (SCZ) is made exclusively clinically, since specific biomarkers that can predict the disease accurately remain unknown. Machine learning (ML) represents a promising approach that could support clinicians in the diagnosis of mental disorders.
Objectives: A systematic review, according to the PRISMA statement, was conducted to evaluate its accuracy to distinguish SCZ patients from healthy controls.
Methods: We systematically searched PubMed, Embase, MEDLINE, PsychINFO and the Cochrane Library through December 2018 using generic terms for ML techniques and SCZ without language or time restriction. Thirty-five studies were included in this review: eight of them used structural neuroimaging, twenty-six used functional neuroimaging and one both, with a minimum accuracy >60% (most of them 75–90%). Sensitivity, Specificity and accuracy were extracted from each publication or obtained directly from authors.
Results: Support vector machine, the most frequent technique, if associated with other ML techniques achieved accuracy close to 100%. The prefrontal and temporal cortices appeared to be the most useful brain regions for the diagnosis of SCZ. ML analysis can efficiently detect significantly altered brain connectivity in patients with SCZ (eg, default mode network, visual network, sensorimotor network, frontoparietal network and salience network).
Conclusion: The greater accuracy demonstrated by these predictive models and the new models resulting from the integration of multiple ML techniques will be increasingly decisive for early diagnosis and evaluation of the treatment response and to establish the prognosis of patients with SCZ. To achieve a real benefit for patients, the future challenge is to reach an accurate diagnosis not only through clinical evaluation but also with the aid of ML algorithms.

Keywords: machine learning, schizophrenia, support vector machine, resting-state fMRI, sMRI, multivariate pattern analysis

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